Practice Management
An 11-year-old male presents to urgent care complaining of bilateral heel pain, right worse than left. The patient denies recent trauma and reports experiencing increased pain when running. He has not tried any treatment and denies any history of similar episodes in the past. Physical examination reveals bilateral pes planus and decreased dorsiflexion of the feet with weightbearing lunge against the wall. Pain is elicited with calcaneal compression test. The patient is noted to be …
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An 80-year-old male with hypertension and hyperlipidemia presents to urgent care for 1 day of sharp, substernal chest pain radiating to his right arm with associated shortness of breath and diaphoresis. His wife notes that he is often nonadherent with his medications. An ECG is ordered. View the ECG and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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A 42-year-old woman with widespread scaly lesions presents to urgent care. On exam, the provider noted superficial crusts and exfoliative plaques seen on the face, neck, and chest. The patient reported that the lesions were painful, but she had no systemic symptoms and felt fine otherwise. The rash emerged a couple of months prior. The patient had no recent history of travel or infections and was not currently on any medications. The urgent care took …
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A 42-year-old man presents to urgent care on a Sunday afternoon. He explains that he was playing a game of pick-up football in his neighborhood and suffered a rough kick to the face from another player. His nose is swollen, and he’s clearly in pain. An x-ray is ordered to capture a lateral view of the nasal bones. Review the image and consider what your diagnosis and next steps would be. Resolution of the case …
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A 56-year-old female with no past medical history presents to urgent care with 2 episodes of chest pain that woke her up this morning. She had 2 additional episodes while walking and while bathing earlier in the day. The episodes lasted about 10 minutes each, and she is currently free from chest pain. The pain is pressure-like and left-sided, radiating to her back. An ECG is obtained. View the ECG and consider what your diagnosis …
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A 3-week-old girl presents to urgent care with widespread scaly skin. On physical examination, her vital signs are normal. She is noted to have ectropion and large, thick, plate-like scales covering most of her body. The patient had a personal history of prematurity and collodion membrane at birth. There is no family history of dermatological or genetic disorders. View the image below and consider what your diagnosis and next steps would be. Resolution of …
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A 13-year-old boy presents to urgent care after “rolling” his left foot. He explains that he tripped on a cement curb while riding his skateboard. He has foot and ankle pain that is worse with weight. An x-ray is ordered. Review the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.
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A 33-year-old female presents to urgent care with pleuritic chest pain that is gradual in onset over the preceding several days and worse when lying flat. She denies fever, cough, and shortness of breath. She is well appearing with normal vital signs. An ECG is obtained. View the ECG and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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A 63-year-old man presents to urgent care with sudden-onset floaters and blurred vision in his right eye for one day. He denies trauma, headache, or flashes of light. He has no history of similar symptoms. His past medical history includes hypertension and type 2 diabetes. Vital signs are normal. Visual acuity measures 20/40 OD and 20/25 OS. No facial asymmetry or eyelid swelling is noted. Visual fields are intact bilaterally. A non-dilated fundoscopic exam is …
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A 55-year-old woman presents to urgent care because of skin dryness and scaling on her legs that developed 2 weeks prior. The patient was recently diagnosed with psoriasis by a different provider and was treated with a combination therapy of tazarotene and a topical steroid for over 4 weeks. Diffuse dryness and white scales were seen on her legs. View the image below and consider what your diagnosis and next steps would be. Resolution of …
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